Liver transplantationComplication: SugicalChronic Hepatic Artery Occlusion with Collateral Formation: Imaging Findings and Outcomes

ObjectiveThe imaging findings, clinical presentation, and outcome in post liver transplantation patients with hepatic arterial collaterals are reviewed.Materials and MethodsAdult post orthotopic liver transplantation patients who underwent an angiography at our institution for suspected hepatic arterial abnormality during an approximately 10-year period were included in our study. A retrospective review of all cases that had hepatic arterial collaterals detected on angiography was then performed. Angiographic findings were correlated with the findings on ultrasound and other imaging studies. Liver function at the time of angiography was recorded. Clinical outcomes were reviewed.ResultsOf the 129 angiographies performed in the approximately 10-year period, 24 (19.4%) were found to have collaterals on angiography. Maximum size of the collaterals seen on angiography was 3 mm. Twenty patients (83%) with collaterals are currently alive. Twelve patients (50%) had a normal outcome and did not develop any complications on follow-up; however, the rest developed complications. Eleven patients (41.7%) had complication related to the liver ischemia and 2 patients (8.3%) developed malignancy (posttransplant lymphoproliferative disease).ConclusionCollaterals seen in patients with chronic hepatic artery occlusion are usually small in caliber and their significance is unclear. Recognition and understanding of this phenomenon is important as this subset of patients may not need urgent surgical re-exploration/vascular intervention.